Preface

alaria is a major public health problem in India, accounting for sizeable morbidity, mortality and economic loss. Apart from preventive measures, early diagnosis and complete treatment are the important modalities that have been adopted to contain the disease. In view of widespread chloroquine resistance in Plasmodium falciparum infection, and other recent developments, the national policy has been revised to meet these challenges. The guidelines on ‘Diagnosis and Treatment of Malaria in India (2009)’ have been developed during the brainstorming meeting organized by the National Institute of Malaria Research (NIMR) and sponsored by WHO Country Office in India. These guidelines are the collaborative effort of National Vector Borne Disease Control Programme, National Institute of Malaria Research and experts from different parts of the country. The aim of this endeavour is to guide the medical professionals on the current methods of diagnosis and treatment based on the national drug policy (2008). This manual deals with the treatment of uncomplicated malaria and specific antimalarials for severe disease. The general management should be carried out according to the clinical condition of the patient and judgement of the treating physician. The warning signs of severe malaria have been listed so as to recognize the condition and give the initial treatment correctly before referring them to a higher facility. It is hoped that these guidelines will be useful for doctors involved in the management of malaria. Director, NIMR Director, NVBDCP

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2. 10. 5. 7. Introduction Clinical features Diagnosis Treatment of uncomplicated malaria Severe malaria Chemoprophylaxis Recommended reading Annexure Contributors Feedback Form 1 1 2 3 8 11 12 13 18 . 6. 3. 9.Contents 1. 4. 8.

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arthralgia. of which 40–50% are due to Plasmodium falciparum. The symptoms of malaria can be non-specific and mimic other diseases like viral infections. Malaria should be suspected in patients residing in endemic areas and presenting with above symptoms. vivax. Although malaria is known to mimic the signs and symptoms of many common infectious diseases. It can be intermittent with or without periodicity or continuous. A revised National Drug Policy on Malaria has been adopted by the Ministry of Health and Family Welfare in 2008 and these guidelines have therefore been prepared for clinicians involved in the treatment of malaria. Clinical features Fever is the cardinal symptom of malaria. nausea and vomiting. myalgia. 2. Introduction Malaria is one of the major public health problems of the country. enteric fever etc. the other causes should also be suspected and investigated in the presence of following manifestations: 1 . Around 1. falciparum relative to P. Prompt and effective treatment is also important for controlling the transmission of malaria.5 million confirmed cases are reported annually by the National Vector Borne Disease Control Programme (NVBDCP). It should also be suspected in those patients who have recently visited an endemic area. chloroquine-resistant P. The continued treatment of such cases with chloroquine is probably one of the factors responsible for increased proportion of P. The fever is often accompanied by headache. anorexia. Many cases have chills and rigors. In the past.Guidelines for diagnosis and treatment of malaria 1. chloroquine was effective for treating nearly all cases of malaria. falciparum malaria has been observed with increasing frequency across the country. Delay in treatment may lead to serious consequences including death. Malaria is curable if effective treatment is started early. In recent studies.

The latter kits are expensive and temperature sensitive.int/sites/rdt). cough and other signs of respiratory infection • Diarrhoea/dysentery • Burning micturition and/or lower abdominal pain • Skin rash/infections • Abscess • Painful swelling of joints • Ear discharge • Lymphadenopathy All clinically suspected malaria cases should be investigated immediately by microscopy and/or Rapid Diagnostic Test (RDT). It also helps to quantify the parasite load. • It is possible to distinguish the various species of malaria parasite and their different stages. falciparum at locations where microscopy results are not obtainable within 24 hours of sample collection. while others can detect other parasite species also. The advantages of microscopy are: • The sensitivity is high.1 Microscopy Microscopy of stained thick and thin blood smears remains the gold standard for confirmation of diagnosis of malaria. NVBDCP supplies RDT kits for detection of P. 3. Several types of RDTs are available (http://www.Guidelines for diagnosis and treatment of malaria • Running nose. Presently. 3. Some of them can only detect P.wpro.2 Rapid Diagnostic Test Rapid Diagnostic Tests are based on the detection of circulating parasite antigens. It is possible to detect malarial parasites at low densities. falciparum. Diagnosis 3. 2 .who.

It should be noted that Pf HRP2 based kits may show positive result up to three weeks of successful treatment. so there may be differences in the contents and in the manner in which the test is done. The user’s manual should always be read properly and instructions followed meticulously.25 mg/kg daily for 14 days under supervision.Guidelines for diagnosis and treatment of malaria RDTs are produced by different companies. 4. The results should be read at the specified time. 4. Treatment of uncomplicated malaria All fever cases diagnosed as malaria by RDT or microscopy should promptly be given effective treatment. vivax cases should be treated with chloroquine in full therapeutic dose of 25 mg/kg divided over three days. infants and pregnant women. Failure to observe these criteria can lead to false/negative results. Primaquine is contraindicated in G6PD deficient patients. It is the responsibility of the clinician or technician doing a rapid test for malaria to ensure that the kit is within its expiry date and has been transported and stored under recommended conditions. Caution should be exercised before administering primaquine in areas 3 . The relapse rate in vivax malaria in India is around 30%. primaquine may be given at a dose of 0. Vivax malaria relapses due to the presence of hypnozoites in the liver.1 Treatment of P. vivax cases Positive P. Early diagnosis and treatment of cases of malaria aims at: • Complete cure • Prevention of progression of uncomplicated malaria to severe disease • Prevention of deaths • Interruption of transmission • Minimizing risk of selection and spread of drug resistant parasites. For its prevention.

bluish discolouration of lips.Guidelines for diagnosis and treatment of malaria known to have high prevalence of G6PD deficiency. Chhattisgarh.1 What is ACT? ACT consists of an artemisinin derivative combined with a long acting antimalarial (amodiaquine. Presently. Madhya Pradesh and Orissa (see annexure). falciparum cases The treatment of P. vomiting etc. These rapidly acting drugs. Other ACTs which will be registered and authorized for marketing in India may be used as alternatives. falciparum cases found positive by microscopy or RDT. it should be tested if facilities are available.2. 4. Artemisinin Combination Therapy (ACT) should be given in resistant areas whereas chloroquine can be used in sensitive areas.2. yellow conjunctiva. therefore. 4. Primaquine can lead to hemolysis in G6PD deficiency. abdominal pain. mefloquine or sulfadoxine-pyrimethamine). ACT should be given only to confirmed P. falciparum malaria is based on areas identified as chloroquine resistant/ sensitive as listed in annexure. 4 .2 Treatment of P. and should report to the doctor immediately. Patient should be advised to stop primaquine immediately if he develops symptoms like dark coloured urine. Jharkhand.2 Should artemisinin derivatives be given alone? Artemisinin derivatives must never be administered as monotherapy for uncomplicated malaria. lumefantrine. if used alone.2.3 Treatment in chloroquine-resistant areas Areas which qualify for ACT • High Pf endemic districts in seven North-eastern states. can lead to development of parasite resistance. nausea. Artemether + Lumefantrine fixed dose combination and blister pack of artesunate + mefloquine are also available in the country. 4. 4. The ACT used in the national programme in India is artesunate + sulfadoxine-pyrimethamine (SP). Andhra Pradesh.

The recommended treatment in the first trimester of pregnancy is quinine. ACTs can be given in the second and third trimester of pregnancy.3 Treatment of mixed infections Mixed infections with P. 4. if RDT is negative and a microscopy result cannot be obtained within 24 hours? If RDT for only P. 5 . 4.4 Treatment based on clinical criteria without laboratory confirmation All efforts should be made to diagnose malaria either by microscopy or RDT. if neither RDK nor microscopy is available? ‘Clinical malaria’ cases should be treated with chloroquine in full therapeutic dose. What is the treatment. special circumstances should be addressed as mentioned below.2. falciparum should be treated as falciparum malaria. If a slide result is obtained later. What is the treatment. 4. the treatment should be adjusted according to species. falciparum is used.Guidelines for diagnosis and treatment of malaria • Other chloroquine resistant PHCs and clusters of blocks surrounding identified drug resistant foci (see annexure). However. Individual cases who qualify for ACT • Patients with history of travel to listed areas.4 Can ACTs be given in pregnancy? According to current WHO guidelines. • No clinical or parasitological response to full dose of chloroquine within 72 hours of starting the therapy. negative cases showing signs and symptoms of malaria without any other obvious cause for fever should be considered as ‘clinical malaria’ and treated with chloroquine in full therapeutic dose of 25 mg/kg body weight over three days.

The first dose should be given under observation. and await microscopy result Microscopy result • + ve for Pv .PQ for 14 days under supervision. falciparum ACT 3 days + PQ single dose (listed areas. • + ve for Pf .Guidelines for diagnosis and treatment of malaria General recommendations for the management of uncomplicated malaria • Avoid starting treatment on an empty stomach.ACT 3 days + PQ single dose in listed areas (Annexure) or CQ 3 days + PQ single dose 6 *Look for other causes of fever. Dose should be repeated if vomiting occurs within 30 minutes. vivax CQ 3 days + PQ 14 days P. Annexure) or CQ 3 days + PQ single dose Negative Needs further evaluation* Where microscopy result is not available within 24 hours Clinical suspected malaria case Perform RDT RDT for Pf. The algorithm for diagnosis and treatment is as follows: Where microscopy result is available within 24 hours Clinically suspected malaria case Take slide for microscopy P. Also prepare blood smear Pf RDT positive ACT 3 days + PQ single dose in listed areas (Annexure) or CQ 3 days + PQ single dose RDT for Pf & Pv Combo RDT Positive: Treat according to species/area Negative: Needs further evaluation* Pf RDT Negative Send blood slide to laboratory Give CQ for 3 days. if there is no improvement after 48 hours or if the situation deteriorates. repeat blood slide examination after an appropriate interval . • The patient should also be examined for concomitant illnesses. • The patient should report back.

vivax and P. of tablets (2.5 15 30 45 No. vivax (Daily Dosage for 14 days) Age in years <1 1–4 5–8 9 – 14 15 & above Daily dosage (in mg base) Nil 2.0 No.5 5. of tablets (7.5 mg base) 0 1 2 4 6 Note: Primaquine should be given for 14 days under supervision.0 15. falciparum (Single dose on first day) Age in years <1 1–4 5–8 9 – 14 15 & above Dosage (in mg base) Nil 7.0 10. falciparum cases in areas considered to be chloroquine sensitive Age in years <1 1–4 5–8 9 – 14 15 & above Number of tablets Day 1 Day 2 (10 mg/Kg) (10 mg/Kg) ½ 1 2 3 4 ½ 1 2 3 4 Day 3 (5 mg/Kg) ¼ ½ 1 1½ 2 Table 2. Do not give Primaquine to pregnant women and infants and G6PD deficiency cases.Guidelines for diagnosis and treatment of malaria Table 1.5 mg base) Nil 1 2 4 6 Table 3. Primaquine for P. 7 . Chloroquine for P. Primaquine for P.

<70 mm Hg in children) • Abnormal bleeding and DIC 8 . if not treated promptly and adequately. falciparum infection over a span of time as short as 12 – 24 hours and may lead to death. SP – Sulfadoxine 500 mg + Pyrimethamine 25 mg 5.Guidelines for diagnosis and treatment of malaria Table 4. Severe malaria 5. ACT (Artesunate + SP) dosage schedule for P. falciparum cases in chloroquine resistant areas Age in years <1 1–4 5–8 9 – 14 15 and above AS SP AS SP AS SP AS SP AS SP Number of tablets 1 Day 2nd Day 3rd Day st ½ ¼ 1 1 2 1½ 3 2 4 3 ½ Nil 1 Nil 2 Nil 3 Nil 4 Nil ½ Nil 1 Nil 2 Nil 3 Nil 4 Nil AS – Artesunate 50 mg. Severe malaria is characterized by one or more of the following features: • Impaired consciousness/coma • Repeated generalized convulsions • Renal failure (Serum Creatinine >3 mg/dl) • Jaundice (Serum Bilirubin >3 mg/dl) • Severe anaemia (Hb <5 g/dl) • Pulmonary oedema/acute respiratory distress syndrome • Hypoglycaemia (Plasma Glucose <40 mg/dl) • Metabolic acidosis • Circulatory collapse/shock (Systolic BP <80 mm Hg.1 Clinical features Severe manifestations can develop in P.

5. antibiotics. where they are available. 5. health facilities should be equipped with the following: • Parenteral antimalarials. Efforts should be made to confirm these cases by RDT or repeat microscopy. 9 . anticonvulsants. they need prompt attention.2 Can cases of severe malaria be negative on microscopy? Microscopic evidence may be negative for asexual parasites in patients with severe infections due to sequestration and partial treatment.Guidelines for diagnosis and treatment of malaria • Haemoglobinuria • Hyperthermia (Temperature >104 F) • Hyperparasitaemia (>5% parasitized RBCs in low endemic and >10% in hyperendemic areas) Foetal and maternal complications are more common in pregnancy with severe malaria. therefore. the patient must be referred without delay to a facility.3 Requirements for management of complications For management of severe malaria. such a case should be treated accordingly. However. o 5. if the symptoms clearly point to severe malaria and there is no alternative explanation. antipyretics • Intravenous infusion equipment and fluids • Special nursing for patients in coma • Blood transfusion • Well-equipped laboratory • Oxygen If these items are not available.4 Specific antimalarial treatment of severe malaria Severe malaria is an emergency and treatment should be given promptly.

v. Loading dose of 20 mg/kg should not be given.m. then once a day (Care should be taken to dilute artesunate powder in 5% Sodium bi-carbonate provided in the pack). clindamycin 10 mg/kg bw 12 hourly for 7 days should be used). ACT containing mefloquine should be avoided in cerebral malaria due to neuropsychiatric complications. given on admission then 1. if the patient has already received quinine. for 3 days in adults only (not recommended for children).6 mg/kg per day. (Doxycycline is contraindicated in pregnant women and children under 8 years of age. • αβ Arteether: 150 mg daily i. given on admission (time=0). dose should be reduced to 7 mg/kg 8 hourly. the further follow-up treatment should be as below: Patients receiving parenteral quinine should be treated with oral quinine 10 mg/kg three times a day to complete a course of 7 days. or i. infusion rate should not exceed 5 mg/kg per hour. • Artemether: 3.4 mg/kg i.Guidelines for diagnosis and treatment of malaria Parenteral artemisinin derivatives or quinine should be used irrespective of chloroquine sensitivity • Artesunate: 2. However.m. instead. then at 12 hours and 24 hours.v. • Quinine: 20 mg quinine salt/kg on admission (i. Patients receiving artemisinin derivatives should get full course of oral ACT. If parenteral quinine therapy needs to be continued beyond 48 hours. 10 . along with doxycycline 3 mg/kg per day for 7 days. NEVER GIVE BOLUS INJECTION OF QUININE.m. infusion in 5% dextrose/dextrose saline over a period of 4 hours) followed by maintenance dose of 10 mg/kg 8 hourly. Note: • Once the patient can take oral therapy.2 mg/kg i.

parenteral artemisinin derivatives are preferred. Note: Mefloquine is contraindicated in cases with history of convulsions.5 mg/kg for children more than 8 years old.Guidelines for diagnosis and treatment of malaria • Intravenous preparations should be preferred over intramuscular preparations • In first trimester of pregnancy. However. Note: Doxycycline is contraindicated in pregnant women and children less than 8 years. 5.5 Can P. 11 . 6. during and four weeks after leaving the area. migrant labourers and military personnel exposed to malaria in highly endemic areas. In second and third trimester. Some cases have been reported in India. falciparum malaria. if quinine is not available. neuropsychiatric problems and cardiac conditions. 6. parenteral quinine is the drug of choice. increased attention has been drawn to severe malaria caused by P. 6. The drug should be started 2 days before travel and continued for 4 weeks after leaving the malarious area. artemisinin derivatives may be given to save the life of mother. vivax lead to severe malaria? In recent years.1 For short-term chemoprophylaxis (less than 6 weeks) Doxycycline: 100 mg daily in adults and 1. Severe malaria caused by P. vivax should be treated like severe P.2 For long-term chemoprophylaxis (more than 6 weeks) Mefloquine: 5 mg/kg bw (up to 250 mg) weekly and should be administered two weeks before. vivax. Use of personal protection measures like insecticide-treated bednets should be encouraged for pregnant women and other vulnerable populations. and there is reason to fear that this problem will become more common in the coming years. Chemoprophylaxis Chemoprophylaxis is recommended for travellers.

especially ACT World Health Organization (2006).int/LinkFiles/Tools_&_Guidelines_ Smallhospitals. Das A. Regional Office for South-East Asia (2006).searo. of India http://www.int/LinkFiles Tools_&_Guidelines_ LargelHospitals. Regional Office for South-East Asia (2006).Guidelines for diagnosis and treatment of malaria 7.nvbdcp. Recommended reading Malaria in India and guidelines for its control including case management Website of National Vector Borne Disease Control Programme http://www.pdf Kochar DK.who. Am J Trop Med Hyg 80 (2): 194 –198. New Delhi. Geneva.pdf RDTs/RDKs Website of WHO Regional Office for the Western Pacific http://www.who. http://www.who.pdf Severe malaria Regional guidelines for the management of severe falciparum malaria in small hospitals World Health Organization.pdf Regional guidelines for the management of severe falciparum malaria in large hospitals World Health Organization. Govt.gov. WHO/SEARO.in/malaria-new. Kochar SK et al. New Delhi. WHO Guidelines for the Treatment of Malaria.gov.html National Drug Policy on Malaria (2008) Ministry of Health and Family Welfare/Directorate of National Vector Borne Disease Control Programme.in/Doc/drug-policy-08. 12 .searo.int/sites/rdt Treatment of malaria in general.nvbdcp.int/malaria/docs/TreatmentGuidelines2006.wpro. World Health Organization http://www.who. (2009) Severe Plasmodium vivax malaria: A report on serial cases from Bikaner in northwestern India. WHO/SEARO http://www.

Dantewada. Darrang. Kamrup M. Khanpur. Arunachal Pradesh (6 districts) Changlang. Dibrugarh. Srikakulam. Dhemaji. Karbi-Anglong.Hills. Raigarh. Bilaspur. Tinsukhia. 6 7 8 13 . N. Golaghat. Karimganj. Entire 24 districts (24 districts) Goalpara. Jorhat. West Kameng 4 5 Chhatisgarh Jagdalpur.. Entire 11 districts (11 districts) Ambikarpur. Name of Districts Name of Chloroquine resistant PHC / surrounding cluster of Block PHCs Entire 5 districts 1 Andhra Pradesh (5 districts) Vizianagaram. Sibsagar. Korea D & N Haveli D & N Haveli (6 PHCs) Whole D & N Haveli (6 PHCs) Goa (2 districts) Gujarat (27 PHCs of 7 districts) North Goa and South Goa (28 PHCs) Panchmahal (4 PHCs) Whole state (28 PHCs) Kadana. Dhamteri. East Godavri. East Entire 6 districts Siang. Cachar (Silchar).C.. Khammam 2 3 A&N Islands Great Nicobar & (2 districts) Little Andaman 20 PHCs Assam Dhubri. Korba. Haila Kandi. Bongaigaon. East Kameng. Lakhimpur. Nalbari. Lunavada. Papum Pare. Lohit. State/UT No. Santarampur contd.Guidelines for diagnosis and treatment of malaria Annexure Districts/Areas identified for use of ACT Combination (AS+SP) for treatment of Pf malaria S. Nagaon. Barpeta. Raipur. Kokrajhar. Morigaon. Jashpurnagar. Visakhapatnam. Kamrup. Kanker. Sonitpur.

Halli Kamatagi. Choryasi.Guidelines for diagnosis and treatment of malaria Gujarat (27 PHCs of 7 districts) Kutch Bhuj (6 PHCs) Anand (2 PHCs) Dahod (3 PHCs) Patan (5 PHCs) Surat (4 PHCs) Kheda (3 PHCs) 9 Jharkhand Gumla. Kopper. Ranchi. Sahibganj. East Lohardagga. Dumka. West Singhbhum.K. Mandavi.. Chelur. Gorewali. Sajjalgudda. Gurugunta. Pakur Karnataka Kolar (7 PHCs) (53 PHCs of 12 districts) Raichur (20 PHCs) Kavada. Galag. Gudibande Echanal. Shivpura. Pattadkal Mangalore Sathegala contd. Santhakallur. Mudgal. Makapur. Masarkal. Hungunda. Arkera. Mahudha. Hirebuddur Kamalpura. Jalahally. Mediknal. Hatti. . Anjar. Anand Degawada. Radhanpur. Limkheda. Gabbur. Kamrej Matar. Dhanpur Lolada. Kamply D. (12 districts) Simdega. Anwari. Godda. Harij. Saraikela. Pathpalya. Nandikeshwar. Bagepally. Mundra. Mehmdabad Entire 12 districts 10 Bellary (2 PHCs) Mandya (1 PHC) Bagalkot (4 PHCs) D. Ramdurga.. Chakavelu. Kannada (1 PHC) Chemarajanagar (1 PHC) 14 Gulur. Olpad. Anehosur. Nagarala. Rapar Surat City. Nakhatrana Pansora. Latehar. Singhbhum. Patadi. Maski.

Pura. Sironcha (5). N. Seoni. Shahdol. Sambalpur.V. Siddhi.Hally A. Chamorshi (2). 2 districts) Gadchiroli (2).Guidelines for diagnosis and treatment of malaria Karnataka (53 PHCs of 12 districts) Gadag (1 PHC) Chitradurga (6 PHCs) Belgaum (1 PHC ) Gulbarga (8 PHCs) 11 12 13 14 15 16 17 Bijapur (1 PHC) Jhabua.K. Bellati Ranganathapura. Kurkunta. Kolasib. Chhindwara. 39 PHCs of Mayurbhanj. Nawarangpura Madhya Pradesh (9 districts) contd. Entire 13 districts districts and Sundargarh.R.. Yelladakere. Koraput. B. Kurkheda (2) Mulchera (2). Kandhamal. Malkhed Almatti Project Entire 9 districts 15 . Jharasguda. Hoshangabad. V. Pettampura. Bhamragad (3). Hal Kakkera. 11 districts) Kalahandi. Gajapati. Mandla. Mamit Entire 3 districts (3 districts) Nagaland All districts (12) Whole state (12 districts) Orissa (13 Keonjhar. Pura Project. Rayagada. Aarmori (2) Manipur All districts (11) Whole state (11 districts) Meghalaya All districts (7) Whole state (7 districts) Mizoram Lunglei. Aheri (3). Rajankallur. Dhanora (5). Guna Maharashtra Raigarh Washi (32 PHCs of Ghadchiroli (31) Korchi (2). Dindori. Malkangiri. Nuapada. Dindawara.G. Betturpalya. J.. Kembhavi Project. Etapalli (3). Gudi Project.

Odapada. Manamunda. Banarpal. Iswarour. Ghasian/patna. Dharakot Gania. Chota Dungara. Baunshini/Boudh Bherhampur. Naikenpali. Belpada. Madhapur/ Athamallic.Guidelines for diagnosis and treatment of malaria Orissa (13 Angul (7 PHCs) districts and 39 PHCs of 11 districts) Bantala. Beltikri/Dhenkanal Tileibbani. Chhatabar/ Riamal.K. Koshala/ Chendipada.. Kanhia. R. Nagar/ Kishorenagar Khajurikata.. 16 . Khamar/ Palalahda. Talwara Kishanganj. Simalwara. Jamla Kanpur. Bomkei. Tarva. Guduvella. Banswara. Shahbad Kotra Dhenkanal (3 PHCs) Deogarh (3 PHCs) Bolangir (6 PHCs) Boudh (3 PHCs) Balasore (3 PHCs) Baragarh (2 PHCs) Cuttack (2 PHCs) Ganjam (4 PHCs) Nayagarh (2 PHCs) Sonepur (4 PHCs) 18 Rajasthan (11 PHCs of 4 districts) Dungarpur (4 PHCs) Banswara (4 PHCs) Baran (2 PHCs) Udaipur (1 PHC) 19 20 Tamil Nadu (1) Tripura (4 districts) Rameshwaram Island All districts (4) Whole state contd. Maniabandha Badagada. Damri. Khaira Bukuramunda. Ullunda Bicchiwara. Bangamunda/ Sindheipalli. Dungurpur Kushalgarh. Madhyakhand Birmaharajpur. Adapada. Bamparda/ Barkot Khaprakhol.Tureikela Adenigarh.

Kurseong. Raipur. Kalimpong. Jhalda-I. Belpahari. Garubathan. Jhalda-II. Sirkabad. Kumargram. Matiali. Mal. Manbazar-I Uttar Latabari. Barabazar. K-Phansidewa. Sukna. Hirbandh Naxalbari. ManbazarII. Alipurduar-II Ranibandh. Sadar. Balarampur. Alipurduar-I. Rajgunj. Sukna. Mirik. Bandhwan. Phansidewa. 37 and 43 West Bengal Purulia (11 PHCs) (39 PHCs of 5 districts) Jalpaiguri (13 PHCs) Bankura (5 PHCs) Darjeeling (8 PHCs) Kolkata Municipal Corporation Total 117 districts (50 WBD + 67 NE states + 256 PHCs of 48 districts) 17 . Madarihat. Maynaguri. Khatra. Kalimpng-I. Rajgunj Ward No.Guidelines for diagnosis and treatment of malaria 21 22 Uttar Pradesh (1) Mirzapur NTPC Project area Mirzapur Bagmundi. Falakata. Joypur.

in Dr. Delhi e-mail: vkdua51@gmail.com Dr. Delhi e-mail: uarora2006@yahoo.net.com Dr. A. Anup Anvikar.Guidelines for diagnosis and treatment of malaria Contributors Dr. V.S. Sanjib Mohanty.com Mrs. Special Director General (PH) and Director National Institute of Communicable Diseases. G. Former Professor and Head Department of Medicine. Joint Director Ispat General Hospital.who. Rourkela e-mail: sanjibmalaria@rediffmail. Deputy Director National Vector Borne Disease Control Programme. Dua. Cuttack e-mail: bidyutdas@hotmail.P. Professor of Medicine SCB Medical College. Delhi e-mail: drgpsdhillon@hotmail.P. G. Scientist D National Institute of Malaria Research. Shiv Lal. Bikaner e-mail: drdkkochar@yahoo. Joint Director National Vector Borne Disease Control Programme.com Dr. Medical College. Delhi e-mail: neenavalecha@gmail. Officer-in-Charge National Institute of Malaria Research.S. S.P. Delhi e-mail: anvikar@rediffmail.co. Director National Vector Borne Disease Control Programme. A.com Dr. Dhanpat Kumar Kochar. National Professional Officer WR India. Gunasekar.int Dr. Regional Advisor WHO SEARO.com Prof. Usha Arora. New Delhi e-mail: gunasekara@searo.in Dr.com Dr.com NIMR/TRS-06/APR-2009 18 .K. Sonal. Neena Valecha.com Dr. Bidyut Das. Dhillon. Dash. Delhi e-mail: dirnicd@bol. Scientist F National Institute of Malaria Research. Delhi e-mail: gssnvbdcp@gmail. New Delhi e-mail: apdash2@rediffmail.

............................................................................. Are these guidelines useful? : Are they user friendly? Do they give complete information on the subject? : : 4..........................-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Guidelines for diagnosis and treatment of malaria Feedback Form Guidelines for Diagnosis and Treatment of Malaria in India 1. Designation ................................................................... Telephone No.................... ................... 2........ Name ........... Do they give the message : regarding diagnosis and treatment of malaria clearly? Any suggestion to improve the guidelines? : 5...... 19 ............................................................. Name and Address of Institute ............................ 3................................................ E-mail: ..................................... .............................

------------------------------------------------------------------------------------------------------------------------------- Please return this form to: Dr. Dwarka New Delhi – 110 077 E-mail: neenavalecha@gmail.com .------------------------------------------------------. Neena Valecha Scientist F National Institute of Malaria Research Sector 8.